| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,229 |
10,661 |
$2.28M |
| D0999 |
Unspecified diagnostic procedure, by report |
4,323 |
2,962 |
$1.39M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,646 |
3,172 |
$598K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
524 |
433 |
$90K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
261 |
234 |
$53K |
| D7140 |
Extraction, erupted tooth or exposed root |
505 |
163 |
$42K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,188 |
1,159 |
$36K |
| D0140 |
Limited oral evaluation - problem focused |
857 |
677 |
$27K |
| D1110 |
Prophylaxis - adult |
380 |
259 |
$21K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
409 |
255 |
$19K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
2,214 |
1,866 |
$16K |
| D0220 |
Intraoral - periapical first radiographic image |
943 |
761 |
$10K |
| D0120 |
Periodic oral evaluation - established patient |
338 |
243 |
$9K |
| D0274 |
Bitewings - four radiographic images |
183 |
118 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
27 |
27 |
$7K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
53 |
26 |
$7K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
32 |
26 |
$5K |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
366 |
274 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$3K |
| D1120 |
Prophylaxis - child |
57 |
44 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
709 |
661 |
$2K |
| 99000 |
|
2,443 |
1,971 |
$2K |
| D1206 |
Topical application of fluoride varnish |
52 |
35 |
$2K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
151 |
87 |
$1K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
394 |
388 |
$938.85 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
98 |
95 |
$503.79 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
28 |
27 |
$312.95 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
13 |
13 |
$310.88 |
| D0270 |
|
46 |
46 |
$0.00 |
| 81002 |
|
114 |
109 |
$0.00 |
| 82947 |
|
161 |
153 |
$0.00 |
| 90662 |
|
16 |
16 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
76 |
40 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
282 |
251 |
$0.00 |
| 90686 |
|
542 |
532 |
$0.00 |
| Q2039 |
Influenza virus vaccine, not otherwise specified |
26 |
26 |
$0.00 |
| 90656 |
|
33 |
32 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
13 |
13 |
$0.00 |